同时性多原发结直肠癌的临床病理和预后研究:Meta分析
Clinicopathological and prognosis of synchronous colorectal cancer:a Meta-analysis
张翔宇 1任万博 1邓凯 1霍新凯 1王新 1赵亮1
作者信息
- 1. 山东大学齐鲁医院德州医院胃肠外科,山东 德州 253000
- 折叠
摘要
目的 探究同时性多原发结直肠癌(synchronous colorectal cancer,SCRC)的临床病理特征,并系统评价其预后、术后并发症发生率及术后 30 d内死亡率.方法 对 PubMed、EmBase、中国知网和维普数据库进行了系统的检索,筛选以英文或中文发表于2001 年 1 月至 2022 年 10 月的研究,提取数据并进行文献质量评价和统计分析.结果 共纳入 17 项研究,共 10 657 例SCRC患者.SCRC患者的 OS、CSS短于孤立性结直肠癌患者(OS:HR=1.17,95%CI:1.06～1.29,P=0.001;CSS:HR=1.54,95%CI:1.16～2.03,P=0.003),但 SCRC与 RFS之间无相关性(HR= 1.06,95%CI:0.96～1.17,P= 0.282);SCRC 患者术后 30 d 内死亡率升高(OR= 1.42,95%CI:1.19～1.70,P=0.00);但术后并发症的发生率升高不显著(OR= 1.63,95%CI:0.99～2.69,P= 0.054).SCRC 患者TNM 分期偏晚,淋巴结转移风险高,易表现为黏液腺癌或印戒细胞癌病理类型和微卫星缺陷型.结论 SCRC 患者预后不良,术后30 d内死亡率高,应加强围术期管理和术后监测.
Abstract
Objective To investigate the clinicopathological features of synchronous colorectal cancer(SCRC)and explore its prognosis,incidence of postoperative complications rate and mortality within 30 days after surgery.Methods Relevant literature was searched on PubMed,EmBase,CNKI and VIP databases.The studies published in English or Chinese from Jan.2001 to Oct.2022 were screened,and the data were extracted for literature quality evalua-tion and statistic analysis.Results A total of 17 studies and 10 657 cases of SCRC patients were included.Compared with patients with solitary colorectal cancer,patients with SCRC had shorter OS and CSS(OS:HR = 1.17,95%CI:1.06-1.29,P=0.001,CSS:HR=1.54,95%CI:1.16-2.03,P=0.003),but there was no significant cor-relation between SCRC and RFS(HR = 1.06,95%CI:0.96-1.17,P = 0.282).The mortality of SCRC patients increased within 30 days after surgery(OR=1.42,95%CI:1.19-1.70,P=0.00).However,the incidence of post-operative complications was not significantly increased(OR=1.63,95%CI:0.99-2.69,P=0.054).SCRC patients were more likely to have advanced TNM stage and lymph node metastasis,and they were proned to mucinous adenocarci-noma or sig-ring cell carcinoma pathological type and microsatellite defect type.Conclusion SCRC patients have poor prognosis and high mortality within 30 days after surgery.Perioperative management and postoperative monitoring are recommended for SCRC patients.
关键词
同时性多原发结直肠癌/预后/Meta分析Key words
Synchronous colorectal cancer/Prognosis/Meta-analysis引用本文复制引用
出版年
2024
NETL
NSTL
万方数据